Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
GenIC #7 (Revised): Cycle Vb (Final Report Template for the Round III AI/AN Cooperative Agreements), Cycle Va (Semi-Annual Template), and Cycle Vb (Monthly and Final Report Templates)
Agency IC Tracking Number:
CMCS
IC Status:
New
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
CMS-10398 #7
HEALTHY KIDS Cycle Va: Semi-Annual Report Template (qualitative report)
HEALTHY KIDS Cycle Va SAR Template with PRA Disclosure.docx
Yes
Yes
Fillable Fileable
Form
CMS-10398 #7
HEALTHY KIDS Cycle Vb: Final Report Template (qualitative report)
HEALTHY KIDS Cycle Vb Final SAR Template with PRA Disclosure.docx
Yes
Yes
Fillable Fileable
Form
CMS-10398 #7
MACRA Cycle Vb, Round III: Final Report Template
MACRA Cycle Vb Round III Final Report Template.docx
Yes
Yes
Fillable Fileable
Form
CMS-10398 #7
HEALTHY KIDS Cycle Vb: Monthly Report Targets vs Other (quantitative reporting)
Monthly report - targets vs other v9_1.11.19.xlsm
Yes
Yes
Fillable Fileable
Form
CMS-10398 #7
HEALTHY KIDS Cycle Vb: Monthly Report (quantitative reporting)
Monthly report v41_1.11.19.xlsm
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
47
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,634
0
1,634
0
0
0
Annual IC Time Burden (Hours)
5,258
0
5,258
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Crosswalk
Crosswalk.xlsx
08/16/2019
GenIC Supporting Statement
GenIC 7 - Supporting Statement (2019 version 5).docx
08/16/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.